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ST. LOUIS — Police say four officers were hit by gunfire after protests in St. Louis that started peacefully Monday became violent overnight, with demonstrators smashing windows and stealing items from businesses and fires burning in the downtown area.The police department tweeted early Tuesday that the officers were taken to a hospital with injuries that were not believed to be life-threatening. It was unclear who had fired the shots.The chaos in St. Louis followed continued protests Monday in Missouri over the death of George Floyd and police treatment of African Americans, with gatherings also held in Kansas City and Jefferson City. 655

Stormy weather in the East claimed at least two lives Monday night.A US Army Reserve soldier was killed and two were injured when severe weather toppled a large tree at Fort Pickett, Virginia, and an 89-year-old man was killed in the Finksburg, Maryland, area when a tree fell on his driveway, trapping him underneath.A cold front moving through the Midwest to the East Coast is bringing relief from a killer heat wave that's blanketed large parts of the United States, but leading it in are heavy rains, strong winds and thunderstorms.The elderly Maryland man was standing in his driveway when high winds from a thunderstorm brought down the tree, the Carroll County Sheriff's Office said.The soldier was taking part in a training exercise when the tree fell at Fort Pickett, the Virginia National Guard said in a 827

Scans of the lungs of the sickest COVID-19 patients show distinctive patterns of infection, but so far those clues offer little help in predicting which patients will pull through. For now, doctors are relying on what’s called supportive care that’s standard for severe pneumonia.Doctors in areas still bracing for an onslaught of sick patients are scouring medical reports and hosting webinars with Chinese doctors to get the best advice on what works and what hasn’t.One thing that’s clear around the globe: Age makes a huge difference in survival. And one reason is that seniors’ lungs don’t have as much of what geriatrics expert Dr. Richard Baron calls reserve capacity.“At age 18, you have a lot of extra lung capacity you don’t use unless you’re running a marathon,” explained Baron, who heads the American Board of Internal Medicine. That capacity gradually declines with age even in otherwise healthy people, so “if you’re an old person, even a mild form can overwhelm your lungs if you don’t have enough reserve.”Here’s what scientists can say so far about treating those who become severely ill.HOW DOES COVID-19 HARM THE LUNGS?The new coronavirus, like most respiratory viruses, is spread by droplets from someone’s cough or sneeze. The vast majority of patients recover, most after experiencing mild or moderate symptoms such as fever and cough. But sometimes the virus makes its way deep into the lungs to cause pneumonia.Lungs contain grapelike clusters of tiny air sacs called alveoli. When you breathe, oxygen fills the sacs and passes straight into blood vessels that nestle alongside them. Pneumonia occurs when an infection -- of any sort, not just this new virus -- inflames the lungs’ sacs. In severe cases they fill with fluid, dead cells and other debris so oxygen can’t get through.If other countries have the same experience as China, about 5% of COVID-19 patients could become sick enough to require intensive careHOW DOES THAT DAMAGE APPEAR?Doctors at New York’s Mount Sinai Health System analyzed 121 chest CT scans shared by colleagues in China and spotted something unusual.Healthy lungs look mostly black on medical scans because they’re full of air. An early infection with bacterial pneumonia tends to show up as a white blotch in one section of one lung. Pneumonia caused by a virus can show up as hazy patches that go by a weird name -- “ground glass opacities.”In people who get COVID-19 pneumonia, that haze tends to cluster on the outside edge of both lungs, by the ribs, a distinctive pattern, said Dr. Adam Bernheim, a radiologist at Mount Sinai.As infection worsens, the haze forms rounder clusters and gradually turns more white as the air sacs become increasingly clogged.HOW TO TREAT THE PNEUMONIA?There are no drugs so far that directly attack the new coronavirus, although doctors are trying some experimentally, including an old malaria treatment and one under development to treat Ebola.“The best treatment we have is supportive care,” said Dr. Aimee Moulin, an emergency care physician at the University of California Davis Medical Center.That centers around assistance in breathing when the oxygen levels in patients’ blood starts to drop. For some people, oxygen delivered through a mask or tubes in the nose is enough. More severely ill patients will need a breathing machine.“The goal is to keep the person alive until the disease takes its course” and the lungs begin to heal, explained Mount Sinai’s Dr. Neil Schachter.The very worst cases develop an inflammatory condition called ARDS -- acute respiratory distress syndrome — that floods the lungs with fluid. That’s when the immune system’s attempt to fight infection “is going crazy and itself attacking the lung,” Baron explained.Many things besides the coronavirus can cause the condition, and regardless of the cause, it comes with a high risk of death.WHAT ELSE IS IMPACTED?Severe pneumonia of any sort can cause shock and other organ damage. But in a webinar last week, Chinese doctors told members of the American College of Cardiology to watch for some additional problems in severe COVID-19, especially in people with heart disease. The worst off may need blood thinners as their blood starts to abnormally clot, and the heart itself may sustain damage not just from lack of oxygen but from the inflammation engulfing the body.Another caution: The sickest patients can deteriorate rapidly, something a hospital in Kirkland, Washington, witnessed.Of 21 patients who needed critical care at Evergreen Hospital, 17 were moved into the ICU without 24 hours of hospital admission, doctors reported last week in the 4639

Special counsel Robert Mueller said in a rare and remarkable public statement Wednesday his investigation could not clear President Donald Trump and that charging the President was not an option his office could consider.In Mueller's first public comments on the investigation since his was appointed special counsel two years ago, Mueller emphasized that Justice Department guidelines did not allow him to charge a sitting President, and as a result his office did not determine whether the President had committed obstruction of justice."If we had confidence the President clearly did not commit a crime, we would have said so," Mueller said. "We did not however make a determination as to whether the President did commit a crime."In what's likely to be his only public statement on the investigation, Mueller's comments highlighted what he wanted to emphasize from 448-page report he issued on the investigation into Russian election interference and possible obstruction of justice.As he announced he was closing the special counsel's office and resigning from the Justice Department, Mueller delivered a road map of how the investigation played out and the possible role that Congress could play in holding Trump accountable."I hope and expect this will be the only time I will speak to you in this manner," he said."It's important the office's written work speaks for itself," Mueller said about his report, which was delivered in March to Attorney General William Barr.The statement was delivered amid political disputes about the findings of Mueller's investigation, particularly regarding whether Trump obstructed justice.The Justice Department 1666

Robert Mueller is done.After a 22-month investigation, charges against 37 defendants, seven guilty pleas and one conviction at trial, the Justice Department announced Friday that the special counsel's office has wrapped up its probe into Russian election interference, possible Trump campaign collusion with Moscow and obstruction of justice.There will be no further indictments from the special counsel, a senior Justice Department official said.The Justice Department informed Congress in a brief letter that Mueller has submitted a confidential report to Attorney General William Barr detailing the decisions his team made to prosecute or not prosecute those who were investigated.Barr said he may provide Congress with "the special counsel's principal conclusions as soon as this weekend."A Justice Department official described the report as "comprehensive" and said those principal conclusions are "expected to be made public."White House press secretary Sarah Sanders said the White House has not seen Mueller's findings."The next steps are up to Attorney General Barr, and we look forward to the process taking its course. The White House has not received or been briefed on the Special Counsel's report," 1226

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